Gastric electrical stimulation in intractable symptomatic gastroparesis
Gastric electrical stimulation in intractable symptomatic gastroparesis
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DOI：
10.1159/000068359
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发表时间：
2002-01-01
期刊：
影响因子：
3.2
通讯作者：
Tougas, G
中科院分区：
文献类型：
--
作者：
Abell, TL;Van Cutsem, E;Tougas, G
背景胃轻瘫的治疗仍然不能令人满意，尽管促动力和止吐药物。胃电刺激已被提出作为一种治疗选择。我们在一项非安慰剂对照研究中评估了胃电刺激对难治性症状性胃轻瘫患者的症状、药物治疗、体重和胃排空的影响。方法：在这项多中心研究中，纳入了38例药物难治性胃轻瘫的高度症状患者。患者首先使用经皮电极接受临时电刺激。33名对临时刺激有反应的患者随后接受了永久性刺激器的手术植入。在刺激前后评估呕吐和恶心的严重程度。在永久性植入后3、6和12个月对患者进行重新评估。结果：通过刺激，35/38例患者（97%）的呕吐和恶心减少>80%。该效应在整个观察期内持续存在（2.9-15.6个月，341患者-月）。胃排空最初没有改变，但在12个月时大多数患者有所改善。在1年，平均体重增加5.5%和9/14的患者最初接受肠内或肠外营养能够中止it. Conclusion：电刺激胃有一个立即和有效的止吐效果。它为难治性症状性胃轻瘫患者提供了一种安全有效的选择。版权所有（C）2002 S. Karger AG，巴塞尔。
Background. The treatment of gastroparesis remains unsatisfactory despite prokinetic and anti-emetic drugs. Gastric electrical stimulation has been proposed as a therapeutic option. We have assessed the effect of gastric electrical stimulation on symptoms, medical treatment, body weight and gastric emptying in patients with intractable symptomatic gastroparesis in a non-placebo-controlled study. Methods: In this multicenter study, 38 highly symptomatic patients with drug-refractory gastroparesis were enrolled. Patients first received temporary electrical stimulation using percutaneous electrodes. The 33 responders to temporary stimulation then underwent surgical implantation of a permanent stimulator. Severity of vomiting and nausea was assessed before and after stimulation. Patients were reassessed 3, 6, and 12 months after permanent implantation. Results: With stimulation, 35/38 patients (97%) experienced >80% reduction in vomiting and nausea. This effect persisted throughout the observation period (2.9-15.6 months, 341 patient-months). Gastric emptying did not initially change, but improved in most patients at 12 months. At 1 year, the average weight gain was 5.5% and 9/14 patients initially receiving enteral or parenteral nutrition were able to discontinue it. Conclusion: Electrical stimulation of the stomach has an immediate and potent antiemetic effect. It offers a safe and effective alternative for patients with intractable symptomatic gastroparesis. Copyright (C) 2002 S. Karger AG, Basel.